Mangano KM, Sahni S, Kiel DP, Tucker KL, Dufour AB, Hannan MT - 46763 N - J Acad Nutr Diet 2015 ; in press.

Bone Mineral Density and Protein-Derived Food Clusters from the Framingham Offspring Study

BACKGROUND: Dietary protein is beneficial to bone health; however, dietary patterns of protein intake and their relationship with bone mineral density (BMD) have not been evaluated.

OBJECTIVE: To examine the relationship of dietary protein food clusters with BMD at the femoral neck, trochanter, total femur, and lumbar spine among middle-aged and older men and women.

DESIGN: Cross-sectional study.

PARTICIPANTS: and setting Two thousand seven hundred fifty-eight community-dwelling individuals from the Framingham Offspring Study.

METHODS: BMD was measured by Lunar DPX-L (Lunar Radiation Corporation) in 1996-2001. Dietary intakes were estimated using the Willett food frequency questionnaire in either 1995-1998 or 1998-2001, and the exam closest to a participant’s BMD measurement was used. Cluster analysis (FASTCLUS procedure, k-means method) was used to classify participants into groups, determined by major sources of protein. Generalized linear regression was used to compare adjusted least-squares mean BMD across protein food clusters for all pairwise comparisons.

RESULTS: From 2,758 participants (44% men; mean age 61+/-9 years, range=29 to 86 years), five protein food clusters were identified (chicken, fish, processed foods, red meat, and low-fat milk). Three of these food clusters showed associations with BMD. The red meat protein food cluster presented with significantly lower femoral neck BMD compared with the low-fat milk cluster (red meat 0.898+/-0.005 g/cm2 vs low-fat milk 0.919+/-0.007 g/cm2; P=0.04). Further, the processed foods protein cluster presented with significantly lower femoral neck BMD compared with the low-fat milk cluster (processed foods 0.897+/-0.004 g/cm2 vs low-fat milk 0.919+/-0.007 g/cm2; P=0.02). A similar, yet nonsignificant, trend was observed for other BMD sites examined. CONCLUSIONS: Diets with the greatest proportion of protein intake from red meat and processed foods may not be as beneficial to the skeleton compared with dietary patterns where the highest proportion of protein is derived from low-fat milk.